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Panel discussion: Pathogenesis of otitis media. Bacteriology and immunology
Author(s) -
Lim David J.,
Demaria Thomas F.
Publication year - 1982
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198203000-00011
Subject(s) - pathogenesis , eustachian tube , middle ear , otitis , immunology , effusion , bacteriology , medicine , antibiotics , immune system , microbiology and biotechnology , bacteria , biology , anatomy , surgery , genetics
Three features of otitis media with effusion (OME) are important in understanding its pathogenesis: 1 . it is most common among children, when the eustachian tube is poorly developed; 2 . it is most common during the winter months, when the common cold is prevalent; and 3 . bacteria are found in a large number of middle ear effusions from OME patients. Although middle ear effusions are conventionally thought to be sterile, numerous recent investigations favor a bacterial pathogenesis of OME. Four possibilities can be considered: 1 . bacteria are modified by antibiotics or antibodies, causing a lingering inflammation; 2 . early antibiotic treatment may interfere with the development of local immunity; 3 . bacterial antigen trapped in the middle ear causes immune injury leading to OME; and 4 . bacterial endotoxin and inflammatory mediators cause middle ear effusions.